Pancreatitis
Pancreatitis is acute or chronic inflammation of the pancreas. It may be caused by infection, or irritation from the pancreas' own production of digestive enzymes. Pancreatitis, whether chronic or acute, usually requires a lowering of dietary fat levelsBD Diabetes-Diet & Exercise for the Diabetic DogBD Diabetes-Diet & Exercise for the Diabetic Cat, which can be tricky to combine with the low-carb diet required by diabetics. This condition plus diabetes usually requires a custom-designed medium-carb diet. Signs While both dogs and cats can suffer from chronic pancreatitis, the species differ when it comes to signs of it. Dogs tend to have repeated acute episodes while cats appear to have gradual inflammation with difficult to pinpoint signs of illnessFeline Pancreatitis-North American Veterinary Conference-2006. Some research indicates that male cats are more prone to be sufferers of chronic pancreatitis than femalesHills Pet Products-Owner's Guide to Pet Care-Pancreatitis. Having diabetes puts dogs at a greater risk of acute pancreatitisBeyond Insulin Therapy: Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U-Queensland 2005. Concurrent with Diabetes There is evidence to suggest that chronic, subclinical (unable to be ascertained through present testing methods) pancreatitis is common in canines with diabetes Dr. Rand, et. al.-Chronic Subclinical Pancreatitis is Common in Diabetic Dogs-University of Queensland 2004. A study conducted by Drs. Fleeman and Rand puts the estimate of canine diabetics with pancreatitis--either acuteImage Illustrating Acute Pancreatitis or chronicImage Illustrating Chronic Pancreatitis--at about 40%Veterinary Clinics of North America-Small Animal Practice-2001-Management of Canine Diabetes-Drs. Fleeman & Rand. Dr. Fleeman also states that it is chronic pancreatitis and the damage it causes to the organ that is responsible for 1/3 of canine diabetes casesBeyond Insulin Therapy:Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U. Queensland, 2005; Dr. Greco echoes this thoughtBetter Medicine E-Newsletter-June 2006. This 2000 lecture given at the District of Columbia Academy of Veterinary Medicine regarding managing acute pancreatitis in dogs and cats refers to an (uncited) study suggesting that cats with pancreatitis are quite sensitive to insulin Pettalk.com-Feline Diabetes. A 1989 study of persons with pancreatitis-caused diabetes also seems to point to the same effect in humansPubMed-Diabetes Care 1989-Pancreatic Diabetes Mellitus, noting that those in the study had low glucagon levels which did not respond normally. The lack of normal glucagon action, which raises blood glucose levels, appears to indicate problems with the way the body responds to hypoglycemia. It goes on to mention that their epinephrine responses to insulin-related hypoglycemia is also abnormal. With epinephrine aka adrenalin acting counter to insulin by raising blood glucose levels, this would seem to further signal problems with the way the body is able to respond to hypoglycemia for those with pancreatitis and diabetes. Another human-based studyJournal of Clinical Pathology 1984-Exocrine Pancreatic Function in Diabetes Mellitus suggests that there is a correlation between the endocrine pancreas associated with diabetes and the function of the exocrine pancreas associated with pancreatitis. Insulin-dependent diabetics were rated as having the most severe exocrine pancreas deficit. Those who were able to control their diabetes with oral medications in the sulphonylurea class were deemed as having intermediate exocrine pancreas deficit. Those who were able to control their diabetes with oral medications of the biguanide class--with or without the help of diet alteration and those who are diet-controlled without any medications, were considered to be free from exocrine pancreas deficit. Causes Some possible causes of pancreatitis: * Obesity/Overweight: This is true for many dogs diangosed with pancreatitis. It is also more likely to develop when a high-fat diet is being fedPet Education-Drs. Foster & Smith-Fats:Nutritional Requirements & Obesity in Dogs. * Hyperlipidemia:or high fat content in the blood. The levels of fat in the blood often rise after eating, but for those without hyperlipidemia, this is a temporary state. Metabolic problems in both pets and people can prevent the removal of fat from the blood. Some studies show that hyperlipidemia can be a cause of pancreatitisHills Pet Care Products-Owner's Guide to Pet Care-Pancreatitis. A low-fat or restricted fat diet is suggested for all diabetic dogs, as it may prevent pancreatitisBeyond Insulin Therapy: Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U-Queensland 2005 * Infections--from either viruses (viral) or bacteria (bacterial) can cause pancreatitis in dogs and cats. * Injury: An injury or trauma to the abdominal area can result in injury to the pancreas; this can mean possible pancreatitis. Dianostics The current blood test for pancreatitis in cats is the SPEC fPL blood test. If you or you veterinarian suspects pancreatitis, a SPEC fPL (sometime also called a PLI for feline PLI test) is highly recommended. This test is currently only performed by Idexx Laboratories and Texas A&M. The fTLI blood test is an unspecific test for feline pancreatitis and more representative of general inflammation of the cat's organs. Diagnosis Pancreatitis is often hard to diagnoseFelinediabetes.com-Pancreatitis. Tests include the serum TLI (Trypsin-Like Immunoreactivity)Texas A & M University-Gastrointestinal Laboratory-TLI Test Information, and the feline or canine PLI (Pancreatic Lipase Immunoreactivity)Texas A & M University-Gastrointestinal Laboratory-PLI Test Information, available from the gastrointestinal laboratory at the College of Veterinary Medicine at Texas A&M University. Turnaround from that lab often takes several days. A canine-specific PLI test is also commercially available through IDEXX Laboratories as the Spec cPL™ TestIDEXX Laboratories-Canine Pancreas-Specific Lipase Spec cPL™ Test. Dr. Williams, who is the director of the GI Lab mentioned above, gave this presentation before the World Small Animal Veterinary Association in 2004WSAVA 2004-Pancreatitis in Cats. He notes no specific signs or symptoms which definitely point to pancreatitis in cats. Labwork for dogs has more clear-cut signs of abnormal values than the results can for cats. Some cats have normal lab results and also have pancreatitis Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis. Rare but possible It doesn't happen frequently, but it is possible for a pancreatitis attack to "jolt" the endocrine portion of the organ back into being capable of producing insulin once again in dogsVet Info--see "Diabetes with rebound hyperglycemia" Question. Treatment It may be very tricky to treat, also. It can cause insulin resistance, dehydration, and also nausea and vomiting, all of which complicate diabetes. Pets can also begin drinking more water. For the most part, they also commonly show a higher than normal temperature when the disease is in its beginning stages. As pancreatitis progresses, the body temperature may go below normalHills Pet Products-Owner's Guide to Pet Care-Pancreatitis. Some recommended treatments to ask your vet about include: * Diet may be important to a pancreatic cat. Some people have had excellent results with a diet that's about :*10-15% calories from carbohydrate :*50-55% calories from protein :*35% calories from fathttp://www.felinediabetes.com/phorum5/read.php?8,555682,556526 Others find that a standard low-carb diet works fine. Some are adamant that fat content is irrelevant to pancreatitis. * "resting" the pancreas by withholdingHills Pet Products-Owner's Guide to Pet Care-PancreatitisFeline Pancreatitis-Drs. Foster & Smith-Pet Education Libraryall food, water and oral medications for a time frame set by your vet. Subcutaneous fluids bypass the oral route; in avoiding the oral route, the pancreas is also avoided. Medical term for this is "nil per os", or "nothing by mouth". * antioxidants to help reduce the inflammation. * pancreatic enzymes to compensate for pancreatic insufficiencyPeteducation.com (Drs. Foster & Smith)-Pancreatic Insufficiency, but only when indicated by the TLI. * Vitamin B12 injections, especially in the case of existing bowel issues * Subcutaneous fluids to combat dehydration. These can be given at home. Complications of Pancreatitis Chronic pancreatitis can lead to maldigestion syndrome in which the pancreas fails to produce enough digestive enzymesPurina ONE Health Library-Diabetes Mellitus. A severe attack is capable of damaging the exocrine pancreas, which produces the digestive enzymes and the endocrine pancreas, which produces insulin. Having a severe attack also puts one at risk for developing chronic pancreatitisCNN.com Health Library-Pancreatitis Overview. This FDMB thread link belowFDMB-Pancreatitis Discussion and followups FDMB-Pancreatitis Discussion Followups deal with alternatives and treatments. Further Reading *Wiki cases--Feline Pancreatitis *Pancreatitis in Cats-Diagnosis & Management of a Challenging Disease-JAAHA-2006 *WSAVA 2001-Feline GI Pearls-Pancreatitis *Sniksnak on Pancreatitis (but W/D food not recommended!) *Pancreatitis and dogs *Pancreatitis in Cats-Drs. Foster & Smith Pet Education Library *Introduction to pancreatitis in dogs and cats *Feline Pancreatitis *See also the discussions on FDMB here, here, and here *Jojo's discussion on the FDMB of Chronic pancreatitis (or does my cat have a pepcid deficiency?) *Pancreatitis in Cats--WSAVA 2004 *Feline Pancreatitis--Underdiagnosed & Overlooked-WSAVA 2003 *Explaining the Differences in Pancreatitis in Dogs & Cats More on both-how Chronic Pancreatitis May Affect Cats' Insulin Needs. * Primer information on pancreatitis *Feline Pancreatitis-WSAVA 2001 *Feline Pancreatitis-Southpaws-Fall, 2000 *Acute Pancreatitis in Cats-Petplace.com *Acute Pancreatitis in the Cat-Anthony Abrams-Ogg *Wiki cases--Canine Pancreatitis * See Canine Diabetes with rebound hyperglycemia for details about how diabetes with pancreatitis can be difficult, at first. Also details how (rarely!) a canine with pancreatitis and diabetes can begin producing insulin again. *Can You Rule Out Pancreatitis? Charts, ultrasound photos and a good review of pancreatitis, with a special section for older dogs. *Pet Education.com-Drs. Foster & Smith-Pancreatitis in Dogs *Acute Pancreatitis in Dogs *Subclinical Pancreatitis is More Common in Overweight and Obese Dogs if Peak Postprandial Triglyceridemia is >445 mg/dl ACVIM 2008, Posters, Page 51, Abstract #336 *Continuing Pancreatic Inflammation or Reduced Exocrine Function Are Common in Dogs After Acute Pancreatitis-Abstract #143, Page51, ACVIM Abstracts, 2006 *Canine Pancreatitis From Clinical Suspicion to Diagnosis and Treatment-WSAVA 2007 *Dog ear infection *Pancreatitis in dogs *Ivermectin for dogs *How long are dogs pregnant *Why do dogs eat grass *Purina dog chow coupons * Discussion about the PLI tests from Antech * Discussion about the PLI tests in the Canadian Journal of Veterinary Research *Explaining the Differences in Pancreatitis in Dogs & Cats *Pancreatitis in Dogs & Cats-WSAVA 2002 *Risk Factors for Pancreatitis in Dogs & Cats-Provet UK *The Perils of Acute Pancreatitis in the Dog and Cat WSAVA 2005 *Lots of good pancreatitis links for cats and dogs Category:Infections Category:Complications Category:Other conditions and procedures Category:Gastrointestinal Disorders References Category:Infections Category:Complications Category:Other conditions and procedures Category:Gastrointestinal Disorders